PACU versus Med-Surg to get to ICU?

[chickel]

Help!!

I am getting ready to start my career in nursing and have two basic options for new grad positions with the intent being to get to the ICU for my experience and then apply to a CRNA program. I need some advise on the best option.

1) Take a 2-year postion in the PACU at a major university teaching hospital and then transfer to the ICU after fulfilling my 2-year commitment in the PACU, then apply for CRNA school. This university offers new grad ICU postions but they are all taken for the year. This position offers a 6-month preceptorship and a 1-year training program with ACLS, PALS certification and the critical care class.

2) Take a position for 6 months to 1 year on a med-surg floor in a Level I Trauma center where I have been working for a year as a nurse intern then transfer to SICU or MICU as soon as possible. This facility will also train ACLS and PALS as well as critical care class upon transfer to the ICU, but preceptorship is only 3 months and less structured than in the university teaching hospital setting. Also, being a county hospital there are fewer resouces at this hospital in general.

Any words of wisdom as to the best/fastest route to CRNA school, which is my ultimate goal? Also, I'm in my late 30's now, so time is somewhat a factor as I'd like to finish school before retirement!

[toobemall]

I guess my first question is do you have to commit to the PACU for 2 years? I ask this because you must keep in mind that one year ICU experience is the minimum requirement for many CRNA programs, and as the competition for seats increases, so may this minimum requirement. Hoepfully, you will get in after one year, but you should plan for another. I myself, am 38, so I understand your time issues.

If, however, the CRNA program is affiliated in any way with the univeristy hospital, it may be to your advantage to take the PACU job. Certainly there you can become a familiar face to CRNAs, MDAs......some of which you may interview in front of at a later time.

I would certanily examine the ICU at the county hospital to see just how sick your patients will be and what kind of experience you will take away from the unit. I believed you mentioned that there were not alot of resources at the county hospital.

Good luck.

[chickel]

Toobemall: Thanks so much for your input. To clarify, the university requires two years commitment for all new graduates; there is no associated signing bonus, just their extra commitment to training. So, I would definitely have to remain in the PACU for the 2 year period. The 'county' hospital is actually a very large facility that gets most Level I traumas from a major metropolitan city and the patients at that facility are very sick. With respect to resources I was referring to the fact that equipment tends to be dated, etc. because about 60% of their client base is uninsured.

Given your response and my own thoughts I'm leaning toward the county facility since as you point out, it would take me three years to get one year in the ICU at the university facility while I would probably get 2+ years in the ICU in that same three year period at the county facility. The university hospital does not have a CRNA program, so there would be no advantage to being in that setting from that prospective.

Thanks again for your help! I need all the help I can get with this decision.